Find a primary doctor who understands CFS and how to treat it, and who helps you feel supported.

Track what helps you feel better, as well as the things that make your symptoms worse.

Use a mix of medical care, daily self-care, and support.

For regular support you can count on, work with a professional counselor, a CFS support group, or both.

Get specialist care when you need it. Sign "release of information" forms so that your doctors can work together as a team.

Treat the worst first

Start by listing your worst symptoms-the ones that make it hardest to get through the day. With your doctor, focus first on treating those symptoms. Decide whether a specialist might be helpful for any of them.

The most common CFS symptoms can also be the most treatable.

Sleep

Good sleep habits can help improve the quality of your sleep. If you also try medicine for sleep, it's best to start on a low dose. Certain antidepressants help with sleep, mood, and chronic pain, so your doctor may suggest trying one.

There are different types of prescription medicines that help with pain, such as antidepressants for chronic pain and narcotic medicine for severe pain. A narcotic is a short-term treatment because it can become addictive if you use it a lot.

Unless your CFS is severe, try a graded exercise program, starting out with gentle and easy movement. Start with as little as 1 minute, and slowly add more over days or weeks. Studies have shown that a carefully planned graded exercise program can help some people with CFS regain their strength and energy and feel better.2

Try cognitive-behavioral therapy (CBT). This is a type of counseling that has been shown to help some people who have CFS feel less tired.2 It teaches you how to change the way you think and do things. These changes can help you better cope with fatigue and other symptoms.

If your doctor suggests an antidepressant, ask if there is one that may not only improve your mood, but also help control your pain and help you sleep.

For support and help with mood problems, you can also work with a professional counselor who understands CFS.

Get specialist care when you need it

You can expect your symptoms to come and go. For some people, certain things trigger long periods of worse symptoms. Visit your doctor every few months to help track your symptoms and check for any need to change your treatment.

Get specialized care if you need it. For example:

A rehabilitation specialist can help you start a graded exercise plan. He or she can also treat pain.

There are some specialists who work with experimental treatments such as antiviral medicines.

Continued

What to think about

There are many unproven remedies, such as special diets or mineral supplements, that some people recommend for treating CFS. There is no evidence that any of these are effective.2

Your mind and body are connected and affect each other. Physical illnesses can be made worse-or better-by your feelings and attitudes, and vice versa. Learn as much as you can about CFS. Then work with your doctor to learn ways to cope with your symptoms. Get emotional support from your health professionals as well as from your family and friends.